Sunday, August 16, 2009

Health Care Reform - Pain and Suffering in America

TodayThe Oregonian ran a story headlined "Medical mistakes kill 200,000 a year in U.S., inquiry finds." Why the death toll? Partly because secrecy of medical records and non-disclosure prevents improvements. Who objects to mandatory disclosure? The AMA and American hospital association of course. The article does not make the connection to the current health care debate, or the AMA's understandable concern the full disclosure could result in lawsuits. On another front, we continue to hear from conservatives that the real reason health care costs so much is the cost of malpractice lawsuits, (frequently using the term "frivolous lawsuits" as though a doctor could never make a mistake) malpractice insurance and defensive medicine. As a part of health care reform, let's deal with both of these problems. First, we completely eliminate jury awards for "pain and suffering" in a medical malpractice lawsuit. But as we do that, let's remember that a pain and suffering award is often a poor surrogate for the lifetime of medical care that will be required for the injured patient. For this scheme to work, there may need to be other limits on malpractice awards as well. Second, As a condition of the first one, a patient injured by a doctor's mistake, would be entitled to free health care related to the injury for life. That may sound like too much to give, but remember, if we have universal health care, this should cost nothing, or very little as insurance carriers would need to be prevented from ever imposing a "lifetime limit" on the cost of care for that patient. Finally, mandatory reporting by doctors. Don't report or get caught in a lie, it could cost you your license. But if you report, take responsibility for your actions? As long as there is universal coverage and no incentive for a lawsuit, there would be little reason for defensive medicine and little or no reason for malpractice insurance. If we want doctors to be medically responsible for their mistakes, then let we need to give them a break from the financial responsibility. If we want all patients to be made whole, then a malpractice claim can't be a windfall for the few who win a lawsuit. And if we want the costs of care to go down, then we need to remove the need for unnecessary - defensive medicine. As for the insurance companies? Well I'm sure they will find some other kind of insurance we just can't live without.